The training activity on breast reconstruction carried on by Prof. Santanelli di Pompeo with DIEP flap, Latissimus Dorsi flap, lipofilling and others procedures, is part of a custom made scientific program to raise the number of surgeons able to perform procedures in the field of microvascular surgery and autologous tissue transfer. Special attention is reserved to the education of young surgeons, with the intention to create a school of surgery aiming at popularizing the DIEP flap procedure in Italy, and to increase the number of plastic surgeons specialized in such technique, in order to make it easily available to those women that have to cope with the difficult experience of beeing addressed to a radical mastectomy.


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Non-Sentinel Lymph Node Metastases Risk Assessment® N-SLNMRA®

Sentinel Lymph Node Biopsy is today considere as the gold standard in axillary staging of breast cancer patients. Although a recent American paper highlights that in case of Sentinel Lymph Node metastasis a Complete Axillary Lymph Nodes Dissection doesn’t impact on survival, this procedure is actually indicated, and only in 35-50% of these patients additional nodal metastases are shown.

To assess the risk of Metastases to the residual Axillary Lymph Nodes several statistic methods were described, starting from the first tool (Memorial Sloan-Kettering Cancer Center Breast Service, 2003). Thus, aim of these tools is to calculate the probability of additional axillary disease in Sentinel Lymph Node positive patients, and the final goal is to avoid unnecessary Complete Axillary Lymph Nodes Dissection in low risk breast cancer patients.

After the validation of the most used published tools, an original method was developed based on the case mix from Sant'Andrea Hospital and other Breast Units, that takes in consideration the following variables to calculate the risk: primary tumor size, histological type, grading, Sentinel Lymph Node metastases size, and positive Sentinel Lymph Node/total Sentinel Lymph Node ratio.

To allow its diffusion and validation the statistical model has been transformed into an "App" for IOS platform, downloadable for free by the Apple Store, designed for mobile devices as iPhone, iPad and iPod, with the goal to provide an helpful and easy decisional tool, with a clinic feasibility and not only in a research environment.


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Redazione Barbara Fabiani